AB1635 RATES OF HIGH LEVELS OF POST-PARTUM DEPRESSIVE SYMPTOMATOLOGY IN WOMEN WITH RHEUMATIC DISEASES FOLLOWED DURING PREGNANCY, AND ASSOCIATIONS WITH TYPE OF DISEASE: A STUDY BY A MULTIDISCIPLINARY TEAM
Authors: F. Crisafulli, E. Pedretti, I. Andreolassi, S. Zatti, F. Ramazzotto, E. Beretta, C. Bani, S. Matthey, A. M. Della Vedova, D. Lini, C. Nalli, M. C. Gerardi, M. G. Lazzaroni, P. Semeraro, M. Fredi, M. Filippini, M. Taglietti, F. Franceschini, L. Andreoli, A. Tincani
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Postpartum depression (PPD) affects 10-15% of Italian women and can lead to adverse outcomes for both mothers and children. Data on the prevalence of PPD in rheumatic diseases (RD) are limited. <h3>Objectives</h3> To assess the frequency of depressive symptoms in post-partum in women with RD using the Edinburgh Post-Natal Depression Scale (EPDS), and to identify potential relationships in patients with arthritis (RA, PsA, SpA, JIA) and connective tissue diseases (CTD: UCTD, SLE, SS, SSc, APS). <h3>Methods</h3> Patients with RD prospectively followed during pregnancy by a multidisciplinary team in an Italian rheumatology unit were included. Disease activity, patient global health (PGH), physician global assessment (PhGA), EuroQoL were collected during pregnancy. EPDS questionnaire was administered at 30-60 days, 6 and 12 months after delivery. Patients with a screen positive EPDS score (9 or more, or a positive response to question 10 -suicidal thought-) were referred to a clinical psychology specialist. Continuous variables are expressed as median (IQR). <h3>Results</h3> From May 2018 to June 2022, 129 patients completed at least one EPDS. Overall, 28 (22%) patients had at least one screen positive EPDS. No differences in health and demographic variables were found between patients screening positive or not, except for a higher PhGA in the 1<sup>st</sup> trimester in the first group (median VAS: 5 [0-20] vs 0 [0-0], p=0.03). Twelve out of 50 patients with arthritis had at least one screen positive EPDS (24%). These patients had a shorter disease duration (p=0.04), a lower PGH in the 1<sup>st</sup> trimester (p=0.03), and a higher frequency of anxious/depressive symptoms (evaluated with EuroQoL) during pregnancy (basal visit: p&lt;0.001; 1<sup>st</sup> trimester: p&lt;0.001; 2<sup>nd</sup> trimester: p=0.01), compared to patients screening negative (Table 1). Sixteen out of 69 patients with CTDs had at least one screen positive EPDS (23%). This group presented higher frequency of anxious/depressive symptoms (EuroQoL) in the 3<sup>rd</sup> trimester (p=0.004) to patients screening negative (Table 1). <h3>Conclusion</h3> More than 1 out of 5 women with RD had substantial level of depressive symptomatology on at least one occasion in the 12 months after delivery on the EPDS. Self-reported symptoms of anxiety and depression should be evaluated during pregnancy and patients could be offered a psychological interview. Our study underlines the need for a closer monitoring of mental health of pregnant women with RD and the opportunity for further studies to identify risk factors and screening procedures. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.